December 3, 2019•Advocacy Matters
Electronic Visit Verification Update – Good Faith Exemption Request
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December 3, 2019
Electronic Visit Verification Update – Good Faith Exemption Request
The 21st Century Cures Act mandated that all states use electronic visit verification for Medicaid funded personal care services by January 1, 2020 and home health services by January 1, 2023. If a state does not implement EVV, the state will be subject to an incremental FMAP (federal medical assistance percentage) reduction.
If a state could demonstrate they made a good faith effort to comply but encountered delays, the state could request a one-year delay to the January 1, 2020 implementation deadline.
Pennsylvania is one of several states applying for a Good Faith Effort Exemption through the Center for Medicaid and Medicare Services. The deadline for the exemption application was November 30, 2019. If approved by CMS, the Pennsylvania Department of Human Services can extend the full launch of EVV by one year.
Good Faith Effort Exemption Requests: State Requests
If CMS fails to approve the Good Faith Effort Exemption or if Pennsylvania does not receive approval by January 1, providers are expected to implement an EVV system by the deadline of January 1, 2020.
What is EVV? EVV requires an individual to use a device which allows providers to log 6 items required by the 21st Century Cures Act. These items include: type of service, name of the individual receiving the service; name of the individual providing the services; date of the service; start and end time of the service; location of the service. The inclusion of tasks performed will be added in the future.
Programs impacted in Pennsylvania are the Consolidated, Person/Family Directed Support Waiver, Community Living Waiver, Adult Autism Waiver,
Office of Long-Term Living Waivers, and Intellectual Disabilities/Autism Base Services, and Community HealthChoices Program.
Many of us in the disability community have expressed concerns about electronic visit verification. We don’t oppose the need to streamline or automate timesheets for direct care workers. We appreciate and support a higher level of accountability for providers and Medicaid.
One concern is the cost for the community. In Pennsylvania, the Department of Human Services and the provider are not providing devices for the community for EVV. If someone can’t afford the device, they can contact a Lifeline program to obtain a telephone.
Other concerns focus on the GPS tracking system in the device that will follow the individual when the individual is engaged in activity outside of the home. The device will follow the individual around the community.
#AdvocacyMatters. It’s important for us to understand electronic visit verification and whether your state has implemented EVV or applied for a good faith effort exemption. Visit www.disabilityrightspa.org for links to learn more.
Pennsylvania Department of Human Services Good Faith Effort Exemption Request
Medicaid.gov EVV Information